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In Case You Missed It:

PSA screening: What doctors tell their patients

Published: August, 2009

The editors of Perspectives polled 15 Harvard-affiliated
physicians — a decidedly unscientific survey — to find out what
they tell patients about prostate-specific antigen (PSA)
screening. Most of those polled are internists, the medical
practitioners most likely to have a discussion with a patient
about the risks and potential benefits of PSA screening.
Interestingly, the findings from the American Prostate, Lung,
Colorectal, and Ovarian (PLCO) Cancer Screening Trial and the
European Randomized Study of Screening for Prostate Cancer
(ERSPC) did nothing to change their recommendations: without
exception, what they tell patients now is no different from what
they told patients before the studies were published at the end
of March. A representative sample of replies follows.

"Since many prostate cancers are slow-growing and never spread,
and since treatments for prostate cancer have side effects, to
have value a screening test must be shown to reduce a patient's
risk of suffering (both from the disease and from treatment side
effects) and risk of death. This has not yet been shown for the
PSA test, based on these two long-awaited recent studies. Until
and unless it is, I won't routinely screen the average man
(without any risk factors for prostate cancer) with PSA testing.
But since I don't think it's been conclusively shown that PSA
testing does not reduce a patient's risk of suffering, I
will obtain the test if a patient wants it, after hearing my
assessment of the evidence."

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Daily Health Tip

Enjoy healthier restaurant meals

Restaurants often overdo portion sizes, butter, and salt. But with a few adjustments, restaurant meals can be a wonderful and healthful experience. Substitute brown rice for white, whole-wheat pasta for regular, or beans for French fries. Instead of having an entrée sautéed, ask for it to be broiled or steamed.